More exceptions and problem spaces under the cut
Some drugs taken orally have very low bioavailability, less than 10 per cent and are considered local.
- vancomycin
- erythromycin
- lactulose
Inhalation is also both systemic and local. Systemic for anaesthesia drugs, local for B-agonists, until we reach a certain point when it becomes systemic.
I want to admit that I like the idea of splitting routes and calculating DDD, but I honestly don’t like sacrificing pharmacology for this. What I see at the moment - we don’t have an agreement, we don’t have a strong system with occasional exceptions, but mostly the whole bucket of exceptions, and we have only a month before the scheduled release. Therefore, I don’t think that pushing routes out now is a good idea. Given no agreement, we will have a very low threshold for rolling back to SNOMED.
Proposal:
That’s why I ask you to give a second thought to my idea and replace ‘Maps to’ with some new type of relationship.
We can call it ‘Has effect’ and it will solve all the use cases. It will not ruin the current usage of routes, and it will support the calculations of DDD. Also, as an answer to @Christian_Reich argument that it will take extra steps for analysts to jump to systemic/local effects - ‘Maps to’ requires even more extra steps.
Let’s say during the ETL process, source data gives the ETLes ‘intravenous’. What should poor ETLers do? They should match with an intravenous route non-standard and then jump to systemic/local. Let them match to intravenous (standard), which is super easy and intuitive, and then take one tiny step to systemic with the help of a new relationship.
What do you think?